Drama OSCE dan Long case

Pehh im back ! (for short je haha)


Nak cerita sikit experience exam haritu.Saja cause i may read this in the future hahaha. Sebab ni exam part 2 so semua nya clinical aje. Tinggal OSCE exam dengan long case. OSCE  ni dah lupa nama panjang dia apa haha tapi kira ganti short case lah jugak, so ada 16 stations. 1 minute question reading lagi 6mins with patients.

Hmm (tengah recall what happened during that time haha)

OSCE exam
On first day, i was in the 3rd group went into the stations. Ngam ngam je right before lunch break.
Since kitorang quarantine dari 7 pagi, anyone yang dapat turn last will be a tiring day for them to wait, by time dah exhausted sangat dah sbb quarantine taktau nk buat apa haha.

Seingatnya, im the last person out of 10 students, so first station dapat station surgery. As expected tu adalah station post operative care patient total thyroidectomy. Examiner was Mr A haha, sgt psycho sbb he sat there silent, without any expression.

Sebab dah tahu patient tu ada hypocalcemia, kena elicit all signs. Nampak ada blood pressure set, i asked " do i need to take her bp? ". Time exam tanya aje, kalau takyah buat so tak membazir masa 6 minit tu.  Mr A hanya diam, blunted face, not even blinking his eyes dia macam tenung je. Hah sudah, so nak taknak kena ambil dahtu siapa nak bagi blood pressure reading. Bila tanya group lain yg dapat with other examiner, rupanya tak perlu pun baseline bp sbb dia bagitau. Nyehhhh.

Bagi jimat masa, i left that part the last. Baik habiskan all the SOAP criteria (heh malas explain what soap are) pastu baru buat. haha as expected tengah ambil bp times out. dalam hati, ahh tak kira nak bgtau jugak diagnosis hahaha.Tengok reading calcium 1.89. This patient has hypocalcemia.
Mr A " are you sure?" muka macam nak makan student. Yes she has hypocalcemia, i look at the reading for the second time.

Muka dia still tak puas hati. haha sah sah la betul kot, sampai sekarang im not sure kenapa dia marah gila sebab all the way long tu senyap je. Unless he heard that as hypercalcemia.

-----------------------------------next station----------------------------

dengan clueless keluar bilik, i sat and read the next question. Patient jatuh bangunan baru sampai emergency. emergency + ortho station la pulak ! tak habis lagi feeling tak puas hati station before tu, dapat pulak kes emergency. haha bagai keluar mulut singa masuk mulut harimau.

masuk je bilik, hah meriah pulak haa bilik ramai sangat orang sampai aku sendiri confuse mana satu examiner. nampak ade sorang lelaki berdiri sebelah patient, so aku redah je

" so nurse, apa jadi?"

lelaki tadi gelak dulu, mungkin dia tak sangka aku nak panggil dia nurse. haha! (aku rasa dia berlakon watak houseman sebenarnya lol) dalam hati ahh nurse pun nurse la.

biasa la patient jatuh bangunan kena assess la GCS (glasgow coma scale, student selalu tersalah dgn GSC, well kantoi nampak sgt selalu wayang time wardwork).

eye open when call 3, confused 4 , obey command 6
His GCS is 14 !

Examiner : are you sure ?

Yes!

Examiner : so 3 +4+ 6 is?

Ok 13 ! tepuk dahi. haha kalau dah gelabah 1+1 satu pun jadi 3 pastu confident.

ok panjang lagi station ni malas dah nak cerita hahaha

---------------------------next station---------------------------


Obstetric & Gynaecology

station patient post partum haemorrhage (PPH)

dah insert branula (jarum kt tangan tu haa), aku pun cakap send blood for FBC, GXM, Coag.

Examiner : haa apa? coag coag !

" sorry dr, i would like to send for full blood count, group cross match and coagulation profile" tak habis dia cakap aku jawab dulu sebelum dia marah lagi hehe.

" ideally i will give her 1 pint normal saline (colloid pun boleh) run fast, but i will prime first"

Examiner ni memang terkenal sikit sebab suara dia kuat. Sekali dia jerkah tu pehhh.
Bila buka pintu masuk station ni, aku macam pandang dia dua kali sebab nak make sure that is him.

Examiner : " dahtu, kau nak suruh aku la yang buat ?!"

in a sarcastic way, tapi aku boleh pulak nak tergelak dalam hati hahaha. padahal kalau orang lain sure kecut perut dengar dia marah.

Dah setup drip, Nak prime, pastu tak keluar air ! HAHAHA

Examiner : dah kau tak bukak cap hujung tu dah mmg la tak keluar !

Epic, lol sbb practice selama ni guna yg reuse je so cap dia ntah campak mana, so terlupa pulak nak bukak dlu.


Dah habis tu Prof tanya management

" So how do you manage this patient, listen the cause is uterine atony, jangan nak jawab merapu, i repeat it is because of uterine atony, uterine atony!"

Haa jahh nampak tak uterine atony tu dia ulang sampai 3 kali.
Confirm confirm student awal2 tu jawab management macam kitorang practice ada 4T tu hehehe.

" first resus patient, simultaneously fundal massage, repeat IM Syntometrine, give IV pit 40, 80 maximum up to 120 at the same time prepare patient to OT, inform anaes
, take consent"

Examiner : dah tu kau book OT nak buat apa? nak borak la dengan team anaes? (sarcasm)
hahahaha

"For bimanual compression under anaes" (relax dulu, sbb ktorang blaja bnde tu under anaes haha rupanya takyah pun)

Examiner " hahahaha itu boleh buat kat situ je takpyah OT !"

"Last resort, for hysterectomy prof "

Examiner : haa hysterectomy la, tunggu apaaa lagi ! mati laa patient aku mcm ni.

Dalam hati asyik gelak jee sepanjang station ni, kalau orang lain tengok sure macam kesian apela student ni kena marah, tapi tak rasa kena marah pun haha. Even suara Prof mmg kuat campur sarcastic dia campur gelak mcm evil laugh. hehe
It was 6minutes full of drama. I enjoyed that station really much. Sebab rasa im doing the right things so tak payah takut lah even examiner mcm singa hehehe. (he is really nice anyway). Suka gila kalau die ajar. lawak tp garang juga.

ok lagi la, ada student yg masuk masuk bilik (yela PPH kan case emergency ), ok nurse ape jadi ape jadi? sambil berlakon tgh emergency. tetibe prof ckp

" ahh kau takyah nak drama, insert branula tu dulu"

HAHAHAHAHAHA, kau raseeeeeee?


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ok cukup lah tu, kalau nak cerita semua 16 stations boleh buat novel.
penat dah haa nak taip haha.

LONG CASE EXAM

Dapat examiner yang paaaaaaaaaling taknak,
dapat case yang paaaaaaaaaaaling taknak.

Examiner satu my lecturer, i knew dia punya style, high expectation sikit kt student.
External examiner, HOD hehe rahsia :P

Dapat case paediatrics.
Tengah tengah clerking, patient nak gi toilet !
Hahaha burnt masa, baru tahu rules patient nak gi toilet, masa tak pause. -.-
nyanyi lagu: this world is unfairrrrrrr

dari ambil vital signs (manual) , check respi, cvs, abdo, cns,
skali ENT dgn fundoscopy pun aku buat. oh well kena buat la nak taknak sbb patient takde diagnosis dari ward.

kertas clerking aku, aku tulis heading je
contoh fever, pastu dah.
sebab time mak dia bagi history, aku confuse perjalanan sejarah demam anak dia tu. hahaha complicated gila oii.

tau tau jelah kalau fever in paeds ni hahaha bercabang differential diagnosis (ddx)

bila dia cakap times up. lepas dah habis clerking and examine tu. aku ingat dapat extra 10mins, rupanya yg tadi tu la consider 10mins HAHAHAH.

Dengan hati yang penuh tawakal, aku present depan dua orang examiner tu impromtu sambil aku baca heading aje as a guide.
Part nak present examination findings, aku tgk kertas aku, aku cuma sempat lukis lungs HAHAHA sempat lagi aku gelak dalam hati. Then aku cakap, im sorry Dr i cant remember my exact findings.(nak present terus) so examiner pun ckp takpe " later we will go to your patient"

hehe, selamat. sbb aku tau sure dia suruh aku demonstrate depan dia lagi skali time tu aku just perlu ulang balik je cakap apa positive findings.

banyak sangat soalan dia, sebab aku letak dalam ddx pasal TB, yes, HOD tu tanya aku dari awal sampai ke sudah pasal TB haha.

tapi ada satu soalan examiner tanya part management, ni paling tak boleh lupa, soalan paling senang dalam dunia, soalan ni aku rasa paling bodoh betul sbb tak boleh recall jawapan dia which is
macrolides HAHAHAHA. simple gila kot. (sampai skrg bila fikir insiden ni still rasa malu ahahhaa)

time tu aku try recall, tapi still tak dapat. bila dah habis exam, word macrolide tu muncul dalam otak.
satu je aku fikir time tu,

" ada dosa, sebabtu ilmu terhijab!"

Sure Dr tu rasa " this student dont even know an easy question" wuaaaaaaa

takpelah , hahahaha what is past is past.

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Alhamdulillah, selepas 6 tahun medical school, in which banyak jugak ilmu anatomy first year aku dah lupa, first year kot haha alasan.

Diberi rezeki olehNya, i finally end my medical school and get the MBBS (Bachelor of Medicine and Bachelor of Surgery).

Bagi certain orang, alahhh MBBS je pun takyah poyo lah kan. Haha mmg betul pun, cuma rasa bersyukur sebab habiskan 6 tahun tu adalah satu tempoh yang panjang nak dapatkan degree. Ada sahabat lain 10 years completing med school sbb kena repeat lagi balik Malaysia tapi mashaAllah sangat hebat orang orangnya. Sebab mengenangkan banyak sacrifices been made by orang sekeliling, sbb tu rasa tak percaya dah berjaya habiskan.

 Walaupun banyak lagi dan bertahun tahun lagi kena bertahan dengan cabaran akan dtg, tak salah kita express rasa syukur sebab dah berjaya achieve satu satu benda yang kita nak dalam hidup. Mission yg coming soon, kita bersyukur pula untuk yang seterusnya.

Syukur dengan Tuhan, tanda kita hanya hamba.
Tiada lain hanya untuk beribadah kepada Dia.



(tak pernah tulis elsewhere sbb tak berapa suka nk selfclaim as doc),
moga ini dikira jalan ibadah dari Dia kepada Dia,

Sayang,
Dr Nur Nazihah Mohd Amin